Management of pulmonary thromboembolism in children: an evidence-based expert consensus

Pulmonary Embolism and Pulmonary Vascular Disease Group of the Respiratory Disease Branch of the Chinese Medical Association, Pulmonary Embolism and Pulmonary Vascular Disease Committee of Chinese Association of Chest Physicians, National Pulmonary Embolism and Pulmonary Vascular Disease Prevention and Treatment Collaborative Group. Guidelines for the diagnosis, treatment, and prevention of pulmonary thromboembolism. CMJ. 2018;98:1060–87.

Google Scholar 

Carpenter SL, Richardson T, Hall M. Increasing rate of pulmonary embolism diagnosed in hospitalized children in the United States from 2001 to 2014. Blood Adv. 2018;2:1403–8.

Article  PubMed  PubMed Central  Google Scholar 

Group JJW. Guidelines for the diagnosis, treatment and prevention of pulmonary thromboembolism and deep vein thrombosis (JCS 2009) - digest version -. Circ J. 2011;75:1258–81.

Article  Google Scholar 

Konstantinides SV, Meyer G, Becattini C, Bueno H, Geersing GJ, Harjola VP, et al. 2019 ESC guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J. 2020;41:543–603.

Article  PubMed  Google Scholar 

World Health O. WHO handbook for guideline development. 2nd ed. Geneva: World Health Organization; 2014.

Google Scholar 

Brouwers MC, Kho ME, Browman GP, Burgers JS, Cluzeau F, Feder G, et al. Agree II: advancing guideline development, reporting and evaluation in health care. J Clin Epidemiol. 2010;63:1308–11.

Article  PubMed  Google Scholar 

Chen Y, Yang K, Marušic A, Qaseem A, Meerpohl JJ, Flottorp S, et al. A reporting tool for practice guidelines in health care: the RIGHT statement. Ann Intern Med. 2017;166:128–32.

Article  PubMed  Google Scholar 

Ni XF, Liu JN, Zeng LN. 2025 The Prevelance and risk factors in children and adolescents with pulmonary embolisim: a systematic review and meta-analysis. BMJ open. In press.

Ni XF, Song X, Zeng LN. The role of clinical modeling/scoring and D-dimer in the initial diagnosis of suspected pulmonary thromboembolism in children: a systematic review and meta-analysis. BMJ open. In press 2025.

Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008;336:924–6.

Article  PubMed  PubMed Central  Google Scholar 

Dewidar O, Lotfi T, Langendam MW, Parmelli E, Saz Parkinson Z, Solo K, et al. Good or best practice statements: proposal for the operationalisation and implementation of GRADE guidance. BMJ Evid-Based Med. 2023;28:189–96.

Article  PubMed  Google Scholar 

Pulmonary Vascular Disease Group of the Cardiology Branch of the Chinese Medical Association. Consensus on the Diagnosis and Treatment of Acute Pulmonary Embolism by Chinese Experts (2015). Chin J Cardiol. 2016;44:197–211 (in Chinese).

Google Scholar 

China Thrombosis and Hemostasis Society (CTHS) Guideline Committee. Guidelines for the Prevention and Treatment of Thrombotic Diseases in China. CMJ. 2018;98:2861–88 (in Chinese).

Google Scholar 

Jorens PG, Van Marck E, Snoeckx A, Parizel PM. Nonthrombotic pulmonary embolism. Eur Respir J. 2009;34:452–74.

Article  CAS  PubMed  Google Scholar 

Agha BS, Sturm JJ, Simon HK, Hirsh DA. Pulmonary embolism in the pediatric emergency department. Pediatrics. 2013;132:663–7.

Article  PubMed  Google Scholar 

Sherrod BA, McClugage SG, Mortellaro VE, Aban IB, Rocque BG. Venous thromboembolism following inpatient pediatric surgery: analysis of 153, 220 patients. J Pediatr Surg. 2019;54:631–9.

Article  PubMed  Google Scholar 

Stein PD, Kayali F, Olson RE. Incidence of venous thromboembolism in infants and children: data from the National Hospital Discharge Survey. J Pediatr. 2004;145:563–5.

Article  PubMed  Google Scholar 

Biss TT, Brandão LR, Kahr WH, Chan AK, Williams S. Clinical features and outcome of pulmonary embolism in children. Br J Haematol. 2008;142:808–18.

Article  PubMed  Google Scholar 

Rashid A, Mansoori H, Ali SA, Nasir N. Paediatric thrombosis: a five-year experience from a tertiary care center of Pakistan. J Ayub Med Coll Abbottabad. 2022;34:263–8.

Article  PubMed  Google Scholar 

Hong J, Lee JH, Yhim HY, Choi WI, Bang SM, Lee H, et al. Incidence of venous thromboembolism in Korea from 2009 to 2013. PLoS ONE. 2018;13:e0191897.

Article  PubMed  PubMed Central  Google Scholar 

Kempny A, McCabe C, Dimopoulos K, Price LC, Wilde M, Limbrey R, et al. Incidence, mortality and bleeding rates associated with pulmonary embolism in England between 1997 and 2015. Int J Cardiol. 2019;277:229–34.

Article  PubMed  Google Scholar 

Choi HS, Choi CW, Kim HM, Park HW. Venous thromboembolism in pediatric patients: a single institution experience in Korea. Blood Res. 2016;51:164–70.

Article  PubMed  PubMed Central  Google Scholar 

Ross CE, Shih JA, Kleinman ME, Donnino MW. Pediatric massive and submassive pulmonary embolism: a single-center experience. Hosp Pediatr. 2020;10:272–6.

Article  PubMed  PubMed Central  Google Scholar 

Sadiq MW, Ukrani RD, Arif A, Akbar I, Altaf S, Moiz B. Risk assessment and outcome of venous thromboembolism in pediatric population in an academic care center of a low-middle income country. Clin Appl Thromb Hemost. 2021;27:1076029621995895.

Article  PubMed  PubMed Central  Google Scholar 

Hangül M, Köse M, Pekcan S, Çalışkan Ü, Tokgöz H, Aslan AT, et al. Pulmonary embolism in childhood: a multicenter experience from Turkey. Balkan Med J. 2022;39:366–73.

Article  PubMed  PubMed Central  Google Scholar 

Wolf S, Valerio L, Kucher N, Konstantinides SV, Klaassen ILM, van Ommen CH, et al. Acute pulmonary embolism in children and adolescents in the USA (2016 and 2019): a nationwide retrospective cohort study. Lancet Respir Med. 2025;13:393–402.

Article  PubMed  Google Scholar 

Buck JR, Connors RH, Coon WW, Weintraub WH, Wesley JR, Coran AG. Pulmonary embolism in children. J Pediatr Surg. 1981;16:385–91.

Article  CAS  PubMed  Google Scholar 

Daily PO, Dembitsky WP, Peterson KL, Moser KM. Modifications of techniques and early results of pulmonary thromboendarterectomy for chronic pulmonary embolism. J Thorac Cardiovasc Surg. 1987;93:221–33.

Article  CAS  PubMed  Google Scholar 

Jaff MR, McMurtry MS, Archer SL, Cushman M, Goldenberg N, Goldhaber SZ, et al. Management of massive and submassive pulmonary embolism, iliofemoral deep vein thrombosis, and chronic thromboembolic pulmonary hypertension: a scientific statement from the American Heart Association. Circulation. 2011;123:1788–830.

Article  PubMed  Google Scholar 

Ross PA, Abou-Zamzam A, Newth CJL. Height best predicts the optimal insertion length of orotracheal tubes in children. Intensive Care Med. 2024;2:6.

Google Scholar 

Gu SJ, Wen JL, Wang XY, Zhang LX, Li W, Qi X. Advances in the diagnosis and treatment of in situ pulmonary artery thrombosis. Zhonghua Jie He He Hu Xi Za Zhi. 2024;47:464–9 (in Chinese).

CAS  PubMed  Google Scholar 

Wang W, Chang J, Zhang XJ, Cui J, Liu LP, Han ZY. Severe mycoplasma pneumoniae pneumonia complicated with pulmonary embolism in children: a clinical analysis. Chin Remedie Clin. 2021;21:3954–8 (in Chinese).

Google Scholar 

Bryce YC, Perez-Johnston R, Bryce EB, Homayoon B, Santos-Martin EG. Pathophysiology of right ventricular failure in acute pulmonary embolism and chronic thromboembolic pulmonary hypertension: a pictorial essay for the interventional radiologist. Insights Imaging. 2019;10:18.

Article  PubMed  PubMed Central  Google Scholar 

Ma JR, Song HM, Xiao J, Tang XY, He YY, Wei M. Clinical analysis of 12 patients with pediatric antiphospholipid syndrome with pulmonary embolism. Zhonghua Er Ke Za Zhi. 2017;55:25–9 (in Chinese).

CAS  PubMed  Google Scholar 

Pelland-Marcotte MC, Tucker C, Klaassen A, Avila ML, Amid A, Amiri N, et al. Outcomes and risk factors of massive and submassive pulmonary embolism in children: a retrospective cohort study. Lancet Haematol. 2019;6:e144–53.

Article  PubMed  Google Scholar 

Lei YL, Li ZX, Tan J, Du XK, Shu C. Clinical analysis of 8 cases with pulmonary embolism in children. Zhonghua Shi Yong Er Ke Lin Chuang Za Zhi. 2020;35:852–5 (in Chinese).

Google Scholar 

Kang LL, Zhang SL, Zheng B, Sun LF, Shi SL. Features of the morphological distribution and outcome analysis of 9 cases of concurrent pulmonary artery embolism of mycoplasma pneumonia in children. J Clin Radiol. 2022;41:1331–5 (in Chinese).

Google Scholar 

Li X, Dong LL, Tang Y, Li M, Wang J. Clinical analysis of mycoplasma pneumoniae pneumonia complicated with pulmonary thromboembolism. Chin J Clin Med. 2021;28:328–32 (in Chinese).

Google Scholar 

Liu FQ, Zhang J, Chen X, Ding N, Dai FF, Wang K, et al. Clinical analysis and etiology factors of pulmonary embolism in 30 children. Zhonghua Shi Yong Er Ke Lin Chuang Za Zhi. 2022;37:1386–91 (in Chinese).

Google Scholar 

Yang K, Jia B, Yang PJ, Zhou J. Clinical and imaging characteristics of pulmonary embolism complicating Mycoplasma pneumoniae pneumonia. Physician Online. 2022;12:7–10 (in Chinese).

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